CHAPTER I

INTRODUCTION
A fracture usually results from traumatic injury to a bone, causing the continuity of bone
tissues or bony cartilage to be disrupted or broken. Fractures occur when the bone is subjected
to stress greater that it can absorb. Fractures are caused by direct blows, crushing forces,
sudden twisting motions, and even extreme muscle contractions. When the bone is broken,
adjacent structures are also affected, resulting in soft tissue edema, hemorrhage into the
muscles and joints, joint dislocation, ruptured tendons, severed nerves, and damaged blood
vessels. Body organs maybe injured by the force that cause the fracture or by the fracture
fragments.
Fracture classifications include simple or compound and incomplete or complete. Simple
fractures (often called "closed") are not obvious as the skin has not been ruptured and remains
intact. Compound or Complex fractures (commonly called "open") break the skin, exposing
bone and causing additional soft tissue injury and possible infection. A single fracture means
that one fracture has occurred, and multiple fractures refer to more than one fracture occurring
in the same bone. Fractures are termed complete if the break is completely through the bone
and described as incomplete or "greenstick" if the fracture occurs partly across a bone shaft.
This latter type of fracture is often the result of bending or crushing forces applied to a bone.
Fractures are also named according to the specific part of the bone involved and the
nature of the break. Identification of a fracture line can further classify fractures. Types include
linear, oblique, transverse, longitudinal, and spiral fractures. Fractures can be further subdivided
by the positions of bony fragments and are described as comminuted, non-displaced, impacted,
overriding, angulated, displaced, avulsed, and segmental. Additionally, an injury may be
classified as a fracture-dislocation when a fracture involves the bony structures of any joint with
associated dislocation of the same joint.
Broken bones are slightly more common among children due to their increased level of
activity and among older people due to their lack of exercise and inadequate intake of calcium.
Transverse Fracture is a fracture in which the break is across the bone, at a right angle
to the long axis of the bone. A fractured bone is a catastrophic event that will have a negative
impact on the patients life style and quality of life.
This study is an opportunity for us student nurses to gain insights about fracture of the
femur. This will help us as student nurses to develop empathy for the patients with this kind of
case, know the impact of this condition and sharpen our ability to care for our patient. By
choosing this condition as a case study, the student nurse expects to broaden her knowledge in
understanding and management of fracture, not just for the fulfilment of the course requirements
in Related Learning Experience.